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JCM
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Plastic and Reconstructive Surgery: Cutting-Edge Expert Perspective
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Plastic and Reconstructive Surgery: Cutting-Edge Expert Perspective

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Plastic, Reconstructive and Aesthetic Surgery/Aesthetic Medicine".

Deadline for manuscript submissions: 10 February 2026 | Viewed by 1081

Special Issue Editors

Dr. Roberto Cuomo

E-Mail Website
Guest Editor
Plastic and Reconstructive Surgery Unit, Department of Medicine, Surgery and Neuroscience, University of Siena, Siena, Italy
Interests: plastic and reconstructive surgery; plastic surgery; regeneration; wound healing; skin cancer; breast reconstruction; cosmetic surgery
Special Issues, Collections and Topics in MDPI journals
Dr. Ishith Seth

E-Mail Website
Guest Editor
Faculty of Medicine and Surgery, Monash University, Melbourne, VIC 3004, Australia
Interests: microsurgery; oculoplastic surgery; medical education; breast surgery; applied artificial intelligence; hand surgery
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

The evolution of reconstructive and aesthetic plastic surgery over the past 50 years has been truly remarkable.

All areas of this discipline have inevitably undergone continuous growth and increasing specialization, while technological advancements have profoundly impacted millions of professionals worldwide.

Research into prosthetic devices, flap, and lymphatic microsurgery has driven progress to the point where procedures once considered unthinkable 20 years ago are now possible—thanks also to improvements in anesthetic techniques for pain control and the management of critically ill patients or those undergoing highly invasive procedures.

The refinement of surgical techniques now significantly involves other fields of medicine as well, such as tumor immunobiology, trauma care, and many others.

This Special Issue aims to explore the evolution of reconstructive plastic surgery from a cross-disciplinary perspective, with a focus on the most recent innovations that have shaped this field. 

Dr. Roberto Cuomo
Dr. Ishith Seth
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • plastic and reconstructive surgery
  • new perspectives
  • regeneration
  • microsurgery
  • oncoplastic
  • post bariatric
  • breast implant

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Published Papers (1 paper)

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Review

16 pages, 302 KB  
Review
Hand Surgery Anaesthesia Innovations: Balancing Efficiency, Cost, and Comfort with WALANT, Ultrasound, and Emerging Adjuncts—A Narrative Review
by Omar Shadid, Jennifer Novo, Raj Saini, Gianluca Marcaccini, Brett K. Sacks, Warren M. Rozen, Ishith Seth and Roberto Cuomo
J. Clin. Med. 2025, 14(17), 6146; https://doi.org/10.3390/jcm14176146 - 30 Aug 2025
Viewed by 773
Abstract
Background: Hand surgery is increasingly transitioning from hospital operating theatres to outpatient settings, requiring anaesthetic methods that are efficient, cost-effective, and patient-centred. Traditional anaesthesia, such as general anaesthesia, poses challenges including prolonged recovery and physiological stress. Novel strategies, such as Wide-Awake Local Anaesthesia [...] Read more.
Background: Hand surgery is increasingly transitioning from hospital operating theatres to outpatient settings, requiring anaesthetic methods that are efficient, cost-effective, and patient-centred. Traditional anaesthesia, such as general anaesthesia, poses challenges including prolonged recovery and physiological stress. Novel strategies, such as Wide-Awake Local Anaesthesia No Tourniquet (WALANT), ultrasound-guided distal nerve blocks, and adjunctive approaches (vapocoolant spray, patient-controlled regional analgesia, cryoanalgesia, jet injectors), have emerged to address these limitations. This narrative review consolidates current evidence regarding the efficacy, applicability, and economic implications of these evolving anaesthesia techniques. Methods: A literature search was conducted across MEDLINE, Embase, CENTRAL, and Scopus databases up to 1 June 2025. Inclusion criteria were English-language original studies on WALANT, vapocoolant sprays, ultrasound-guided distal nerve blocks, or emerging adjunctive anaesthesia methods applicable to hand and upper limb surgery. Exclusion criteria included non-English publications and those without original clinical data. Two independent reviewers screened and selected studies, ensuring relevance and methodological quality. Results: WALANT can provide high patient satisfaction, cost savings of 70–85%, and allow for real-time functional testing during surgery. Ultrasound-guided nerve blocks provided targeted analgesia, preserved elbow function, reduced the need for sedation, and improved perioperative efficiency. Adjuncts such as vapocoolant sprays significantly decreased needle-injection discomfort, offering quick and economical analgesia for superficial procedures. Other emerging adjuncts, including patient-controlled regional anaesthesia (PCRA), cryoanalgesia, and jet injectors, offered additional patient-tailored pain management options, although with higher resource demands. Conclusions: The review highlights the transformative potential of WALANT and adjunctive techniques to enhance efficiency, patient experience, and cost-effectiveness in hand surgery. Despite clear benefits, optimal application requires tailored patient selection, clinician familiarity, and consideration of procedure-specific demands. Full article
(This article belongs to the Special Issue Plastic and Reconstructive Surgery: Cutting-Edge Expert Perspective)
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